To have been patronising to the Doctor?

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Sorry, I’ve just read this and it’s long but was very cathartic to write out!!

I have a kidney transplant. I’ve had it for nearly 10 years and was diagnosed with kidney failure after contracting an auto immune disease.

Ive therefore had a LOT of contact with various HCPs over this timeframe and am often taken aback by inappropriate/uneducated comments about it (one RENAL nurse once asked me if my kidneys failed because I ‘ate too much salty foods’ 🙄 .

I was given an emergency appointment this afternoon as I have a painful UTI. I don’t wait to see how these progress but always see GP at first sign as they have travelled to my transplanted kidney before.

Before The appointment I filled in all the online admin about why I was there, what I needed, if I had any conditions etc.

When I went in to see the doctor I started to explain that I’d had some urgency around the toilet. Before I could go any further he interrupted with a ‘let me stop you there…’ and asked me if I was dehydrated, did I do pelvic floor post birth, asked why I had jumped to conclusions that it was a UTI…

I started talking again and explained that I had many before, the feeling was the same … I noticed he wasn’t listening at this point and was looking at his phone. He interrupted again and said he was reluctant to prescribe anything and UTIs can build tolerances…I started to then interrupt him but he put up his hand and went ‘bubububub’ to stop me talking.

He said did I have any pain? I said yes, I was concerned as the pain had travelled up to my kidney and pointed to my pelvis.

He immediately looked very smug and said ‘dear, your kidneys are around your back… i think if the pain is there it may just be your period, or perhaps you pulled a muscle’? He started to stand up and talked about coming back in a week if it hadn’t improved.

At this point I interrupted again and said, in an equally patronising tone ‘dear, you’re right, my non working native kidneys ARE on my back, but my transplanted kidney is at the front and I’m pretty sure I’m at very high risk of hospitalisation if it travels there, which it very much can do as my unrinary tract is shortened’

He spluttered at this point and very abruptly pulled me up for not having mentioned my transplant. I said ‘if you’d have let me finish any one of my sentences or reviewed my notes, you would know this’.

He did end up writing a prescription but tried to have the last word by saying as I walked out ‘next time please do make it very clear you have a transplant’. To which I told him next time to please read the patients notes.

Honestly I’m so sick of being talked over, told what problems might be or even someone trying to tell me (again, GP!!) that I now only had one kidney as I’d had a transplant!!

I despair for anyone who isn’t very well versed in their own conditions and has to navigate these situations and take the word of doctors as gospel!

So AIBU to have replied patronisingly (I NEVER do this and am not quite as quick to quip back as I was today) and should I complain to the practise manager? I don’t know if it’s just the straw that’s broken the camels back!!

and to add, I have some wonderful nurses and doctors on my teams who are amazing which I do recognise!

I worked for years for a software company who supply hospitals with their main patient administration systems.

My role was to research and turn the companies focus based on that research into hospital failings, healthcare policy and everything around these.

I know more about policy than most people in hospitals do.

And I use it whenever its needed.

My daughter was in hospital for abdominal pain and separately she had pain in her legs from an issue she had had from birth.

A consultant came round with several student doctors. He talked over us both. He tried putting the leg pain and abdominal pain together in a diagnosis while talking to the student doctors and dismissed us trying to explain.

As he turned to walk away I stood and said hang on. Before you go. For the benefit of these student doctors I would like to point out your many failings during your examination of my daughter according to your own rules.

You failed to introduce yourself by name and title. You have failed to read the patients notes or any documentation as shown by your lack of awareness about a lifelong issue with her legs. You failed to used human language and by that make clear to non medical folk what you are talking about. You failed to ask the patient any questions beyond where does it hurt.
I pointed out that that departments last inspection by the CQC held them up on very similar failures in patient care requiring improvement. I can see that none of the improvements have been made despite your board papers alluding to new standards.

I then asked if he would like to start again now he has demonstrated to his students how to break most of the rules as set out in the NHS.

Very patronisingly I gave him the first line - repeat after me "hello my name is..."

He looked furious but did comply and went through everything by the book. Turned out my daughter had appendicitis and had her appendix out a few days later.

The nurses came round and said the consultant instructed them to give us anything we need and make sure all observations are carried out exactly to schedule. They said he was absolutly terified of us and thought I was a healthcare reporter or inspector.

Ive had to use my knowledge a few times and have helped friends and family reciece the treatment they deserve too.

So be patronising and pushy. Be a pain to them. Its your health they are dismissing.

My mum has been in hospital for three months. It is astonishing how few clinicians have actually read her notes properly. It has been incredibly frustrating when people have given an update that is total bollocks. My sister has been much blunter that I have and has called them out on it a few times.

Often when you’re dealing with something chronic the patient will know a lot about a specific condition, how to manage flair ups, risks etc and you really do have to be pushy and advocate now.

In an ideal world, sure. But when GP appointments can take several days to secure in parts of the UK, people like me would already be hospitalised. I need same-day antibiotics when a UTI hits so being able to pop into a pharmacy and get them is something I am very grateful exists. Nothing careless about using antibiotics on a raging UTI!

I spoke to a young locum GP at my practice when I had a UTI. I had already tried all the over the counter remedies. She gave me 3 days antibiotics - standard treatment. But not for a diabetic who needs 7 days. I spoke to her 3 times over the next 8 days...she would not prescribe but also obviously would not check with anyone. Finally managed to see my GP and was rushed straight to hospital with sepsis. I was very lucky, after 2 weeks in hospital I was OK.
Sometimes you have to make a fuss.

My ex was a GP and had the biggest god complex going. Some of the shit he used to come out with made me despair for his patients.

He once gave me a lecture for feeding our newborn formula during the night and told me I should be only giving him water for night feeds. 😳

Also told me that ovarian cysts do not cause pain.

I used to reply ‘which textbook did you learn that out of?’ which would wind him up more.

As an attorney, I would argue that I have an obligation to read the salient parts of the client's file if there is one. Professional conduct demands that the lawyer (or doctor) know the history of the client or patient to be able to discharge one's duty properly. The onus is not on the client to educate me. Furthermore, good lawyers are specifically trained to elicit the necessary information through the right qustions, and sift through copious amounts of information. Clients and patients are not obliged to know which information is important to me and which is not.

OP, I think it was right that you had to remind him to allow the patient to finish talking and be up to speed on the notes.

Yes, I'm similar.
I'm on dialysis (not suitable for transplant, unfortunately) and that's the first thing I say at any medical appointment, after many time wasting appointments.
"I am a dialysis patient"

One GP said "yes, thankyou for informing me" in a sarky way.
I don't care, I'll still keep repeating it 😊

OP YANBU
and well done for speaking up. So frustrating...

While I agree that that would be the ideal way to start, doctors shouldn’t interrupt and hold up their hands to stop patients talking just because they haven’t immediately got to the point in the way an perfect patient might. OP knew what she needed so was able to interrupt and state it clearly. But how many other things get missed or dismissed because the patient doesn’t know the exact right thing to focus on, and this doctor just goes “well I’ll stop you right there, this is a non-issue”.

You sound like your client care skills are lacking tbh (also a solicitor). It doesn't take much time at all to allow the client to feel heard before drilling into what you actually need to know. Clients don't always even know what's relevant, it's our job to guide them there.

Great idea, but would a t-shirt be better? And you are not being unreasonable, so thanks for this and to everyone else who's had similar experiences. Knowing it's not just me is a massive relief. I would speak to the practice manager if I were you and ask if your status as a transplant patient could be pinned to the top of your notes rather than complaining. Go on the 'it'll save your valuable time and make things easier for me when I'm feeling lousy and scared because I know what can happen and I hate hospitals' line.

He talks over her, he patronises her and it's her fault because she didn't get the first 5 words right?
No, sorry, can't agree about that.

Doesn't their computer system have a warning box pop up which states you have a kidney transplant? However the GP sounded awful in this case.

I have learned to say:

'I have heart failure, inoperable gallstones due to my co-morbidities, if you do x y and z i can be out of here in 4 to 6 hours. If you do not, the chances are ill go into a fast AF as a response to the spasming and pain levels, risk a bile duct blockage and I'll be with you for a week or to (unless I you actually kill me).'

However whilst this cuts out the 'bubububub' shit, I then get the snarky 'oh are you a medic' or 'oh did you google that' bullshit. No, I did neither, I just know my body and conditions, know you won't read the notes til a week next Tuesday and have been round this particular rodeo several times now.

Before I took this approach, I'd have to endure loads of faffing whilst they tried to work out what was wrong, deny what was actually wrong, try to stuff oral medications down me which I would immediately vomit back up - give me IV cyclazine which makes me trip my tits off (fun, but not very good for you once that phase wears off)... its all a bit of a palaver. I once ended up in for three days whilst a dr who had not read my notes tried to schedule me for a surgery I absolutely could not have, but didn't actually tell me this is why he was hanging on to me (and had he, I'd have told him it wasn't possible). When he DID finally come and say 'well we're going to discharge you now your pain is under control as it turns out we can't operate on you' I said (no longer in a morphine fug) 'But of course you can't... you told me that 6 months ago' . Yup, he hadn't even realised he'd SEEN me before!

Patients can help themselves sometimes by cutting to the chase and delivering the key information swiftly - however many times, for many reasons, they won't be able to - if I am off my tits on IV morphine, or in screaming agony, I am going to talk total biscuits at you. It is the medics job to take a proper history, check any available notes and handover information, it is not MY job, the suffering patient, to pander to their poor bedside manner and lack of people skills.

A lot of doctors are incredibly arrogant. They expect patients to be completely uneducated and tend not to handle it well when they have a knowledgable one.

So well said

I would complain. The ‘bububub’ alone is unacceptable. As you rightly said, you were able to advocate for yourself, but not everyone can.

I often get asked if I'm a doctor/medic.

No. I am an intelligent degree educated professional who can read. I have a medically complex child, I've read widely on her condition including a huge amount of the latest research on it. I tend to understand far more than the average GP about it.

Doctors would do better to respect patients and be delighted by people with a useful bank of knowledge.

The Dr was acting like an arrogant arse.
However, it is not always possible to read everyone’s notes before every appt (especially in a non specialist environment), starting with the most important information. An save everyone time

I don’t know why some HCPs think patients are idiots. Why ask “did you google that”? I have no medical training, have never had appendicitis and have never googled appendicitis, but I could easily list those 5 symptoms of it just from general knowledge.
You’d hardly listed the unusual symptoms of a rare disease!

He is a bad doctor. Can you change practice or have it put on your notes that you don't want to see him again (I'm not sure if you can do that in the Uk but you can in the US).

Well done for standing up for yourself. It's a long hard battle for the chronically ill or those with "invisible" conditions. I know that myself and I'm proud of you.

And I think the badge is an excellent idea. 😂

Good for you, OP. Complain to the Practce Manager.

You were not unreasonable. I also try to start with my relevant medical condition when starting the consultation. For one the best are the doctors (including some specialists) who will say it’s not something they’ve dealt with before. There is a specialist in London and that’s pretty much it.

On the reading the background for some reason there are two ways of getting appointments online for my GP. both ask for details of the reason for contact, , but only one can be seen by the GP. Madnes.

Please write a letter of concern to the Practice Manager!!
Not only should he have at least glanced at your notes (being a transplant recipient should be highlighted for multiple reasons), but having missed it he should have apologised. But also you need to check how he documented the meeting too. If you have a good relationship with your renal team you could let them know too.

I know someone with a kidney transplant and, just as you’ve highlighted, they wouldn’t have spoken up as you did. They would have deferred to the GP and their transplant could have been at risk. His behaviour was not acceptable.

I have an issue with my chest, it's like a version of asthma and anytime I catch a cold it generally turns into a chest infection and I've ended up hospitalised on numerous occasions. I went the the wrong doctor a while ago (there are only 2 at my surgery and 1 of them always a patronising pleb who I refuse to see, but on this case it was him or nothing). I explained my creaking, wheezing chest and how I knew it would be about to get worse and that I'd realised my rescue pack of steroids must have been short dated when I got them as they were now out of date. He listened to my chest and said I didn't have an infection there. I explained that I knew that but a short course of steroids would mean that I likely didn't end back with a worse issue or worse in hospital. I also explained I had something very important coming up and I couldn't afford to be ill for it. He demeaned it instantly saying 'Just because you have some kind of party or something coming up, I can't be giving you medication'. I asked him why he thought me flying 4500 miles for 3 days just for a medical (as I'm emigrating) was deemed a 'party'!?

Like OP I got 'oh you didn't say that' - I didn't think I had to, I just wanted the doctor to make sure I didn't get more ill as I inevitably would have (if he'd looked at my notes when I initially explained this, he would have seen that the pennies (cost price) pack of steroids would save a considerably more expensive hospital stay that neither I nor the NHS really want!!

He ended up giving me steroids and antibiotics that I didn't even want, but weirdly refused to replace my rescue pack despite me clearly showing that I am not taking them willy nilly or they wouldn't have had chance to go out of date 🤷

Ooops, that's a long post, but basically I hear you OP, all too clearly!